NPI Code Details Logo

NPI 1104435999

NPI 1104435999 : JULIE MARIE KELLY MSN, APRN, NP-C : MOUNTAIN VIEW, CA

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1104435999
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    JULIE MARIE KELLY MSN, APRN, NP-C
-----------------------------------------------------
    Gender               |    Female 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    07/28/2020
-----------------------------------------------------
    Last Update Date     |    07/31/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    2525 CHARLESTON RD STE 104 
-----------------------------------------------------
    City                 |    MOUNTAIN VIEW
-----------------------------------------------------
    State                |    CA
-----------------------------------------------------
    Zip                  |    94043-1636
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    918-607-4135
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    2525 CHARLESTON RD STE 104 
-----------------------------------------------------
    City                 |    MOUNTAIN VIEW
-----------------------------------------------------
    State                |    CA
-----------------------------------------------------
    Zip                  |    94043-1636
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    786-234-7345
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    363LF0000X
-----------------------------------------------------
    Taxonomy Name        |    Family Nurse Practitioner
-----------------------------------------------------
    License Number       |    R01127657
-----------------------------------------------------
    License Number State |    OK
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.